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319 Cards in this Set
- Front
- Back
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what usally happens within two years of a teen getting pregnant
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pregnant again
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what are three things that may have a factor with teen pregnancy
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national goals, sex education, socioeconomic implications
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what are the 4 options for teen pregnancy
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sab
tab adoption keeping it |
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what are some interventions for risk for altered health imbalance 5
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eliminate barriers to healthcare, teaching/learning principles, counseling, promoting family support, providing referrals
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what are 3 nursing considerations r/t delayed pregnancy
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reinforce/clarify info, facilitate expression of emotions, provide parenting info
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what is the incidence of substance abuse r/t teens
what about alcohol |
1:10 exposed
1:2drink during preg |
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what are 2 ds r/t alcohol abuse during preg
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fas
fae (effects) |
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fas is associated w cns damage what effect does it have on the baby? what does the baby look like? why is it diff?
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irgr
looks like down syndrome w/o chrom abnormallity |
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fae delays what
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learning abilities
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what is the most common drug used during pregnancy
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marijuana
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how does smoking affect sids stats
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3x more frequent with smoking
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what 3 substances cross the placenta
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thc
alcohol cocaine |
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what affects does thc have on the mother 3
what affects does thc have on the baby 3 |
mom: tachy, anemia, poor weight gain
baby: irritable, tremors, hard to console |
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what affects does cocaine have on the baby 2
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hypoxia, meconium staining
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cocaine causes what pregnancy problem
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abruptio placenta
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with cocaine (abruptio placenta) what 4 things may happen during pregnancy
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ptl
sa pih prom |
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women who do drugs tend to have what
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stds
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what are 2 opiods
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demerol
oxy |
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with a baby what effects does amphetamines and methamphetamines have on the baby
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iugr, bleeding around the brain, baby goes through w/d,\
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with a baby that is going through wd what needs to be done 3
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nicu
move to quiet location give phenobarbetal |
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with heroine abuse what drug is not used
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stadol
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what lab test is done when drug abuse is suspected
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toxicology on mom and baby
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what lab test is done when drug abuse is suspected
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toxicology on mom and baby
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with cocaine and heroin what happens to the body 4
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sweating
increased bp unstable pulses dilated pupils |
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what are the 2 most important inverventions r/t cocaine and heroin
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pain control
preventing heroin w/d |
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what kind of precautions are necessary with dealing with someone w/d
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seizure (pad side rails)
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with the birth of an infant w congenital abnormalities what 2 things need to be adressed
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factors influencing emotional response
grief and mourning |
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what are the nursing considerations r/t abnormalities
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promote bonding/attachment
provide info facilitate communication provide referrals |
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what 3 things should be done w preg loss
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prepare memory packet
provide referalls acknowledge and present infant |
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what 3 things need to be done if woman is suspected of being abused
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develop safety plan
affirming she is not to blame provide referrals |
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what is a missed abortion
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have no idea baby is dead
no clues or s/s |
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with a missed abortion what are you supposed to use
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quantative beta hcg serum
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what is an abortion
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loss of fetus before viability
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what does an abortion show on ultrasound and what does it look like once its out
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blood on utz
brown once out |
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what does black and white rep on utz
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black liquid
white bones |
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what are the 6 types of abortions
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spontaneous, threatened, incomplete, complete, recurrent spontaneous, inevitable
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with a threatened what is the first sign and what needs to be done
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vaginal spotting
beta hcg tests |
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what is an inevitable what do you see
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nothing they can do, vaginal bleeding, ruptured bow, cramping
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what is an incomplete, what is the most likely cause
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you were preg but at some point heart stopped, usually chrom abnormalities
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with an incomplete what needs to be done
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dnc; some comes out but not all
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what is a complete
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like labor or severe period lasting only a few hours (does not need dr)
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what is recurrent spontaneous, what do you give the mother
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3 or more;
usually an underlying medical condition (autoimmune) give prednisone |
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when do you hear heart beat what happens at 14 weeks
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6 weeks
dne |
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wieth dic how often do you need to be monitored
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2 weeks
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with gtd you do what rather than dnc
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vaccume
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bleeding out does what to baby
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stress
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what is an ectopic preg
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distal ends (toward ovary)
proximal (toward uterus) |
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what is pid
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scarred tissue from chlam or gon
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if you have scar tissue in tube what does it do
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makes it hard to move down to uterus (may rupture tube)
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with a ruptured tube what happens
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acute onset abdominal pain with or without spotting
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what are the causes of ectopic preg
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pid
tubal surgeries any reason to have scar tissue |
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with an ectopic preg what are two drugs given
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rhogam and methotrexate (chemo)
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what does methotrexate do
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kills fast growing cells
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what is gestational trophoblastic disease (hydatidiform mole ) (molar preg)
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trophoblast makes placenta huge
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if a tube is not ruptured (found by utz) what needs to be done what if it is ruptured
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beta serum
surgery |
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with gta what test is done
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mri
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chorionic villi gets what
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edematous and large-uterus becomes large and fluid filled
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there is complete and partial what are they; what happens if you keep having a gtd
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complete-full no baby
partial-some embryo may become cancerous |
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what is the biggest indicator of gtd
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increased hcg
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what is a marginal, partial, total (complete) placenta previa
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m- higher than 3 cm from os
p- within 3 cm c- covers os |
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tx depends on how much vag bleeding what happens once you start bleeding
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go to hospital
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what are the risk factors of previa
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ama
more than one fetus surgeries tab |
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what is the first sign of pp and where does bleeding come from
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sudden painless vag bleeding; comes from ch villi
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if mother is stable the mom is sent home if stable on..
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procardia and terbutaline
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what is abruptio placenta
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not good adherance, not getting enough oxygen and may cause ptl
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what is apparent and hidden abruptio placenta; what is worse
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apparent is hem
hidden is consealed hidden worse |
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if clot is placenta it is painful and causes what
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contractions (severity depends on where it is)
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what are some s/s of abruptio placenta
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uterine tenderness
stiff board like uterus increased resting tone b/c irritability (should be 5-10) |
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how do you know if you have ap
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pain
if baby suddenly has iugr |
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what are some risk factors of ap
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cocaine, htn, short umb cord, thrombofilia (usually gets hepatits from thrombofilia)
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what is preeclampsia
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140/90 w/ proteinuria
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what is eclampsia
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140/90 w/ proteinuria and seizures
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what is gestation htn
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increased bp at greater than 20 weeks w/o proteinuria
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what is chronic htn
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increased bp prior to preg (increased risk of preeclampsia)
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how do you find out how much protein is being lost
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24 hour urine catch
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what is the patho of preeclampsia
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with pregnancy, there is an increased vascular volume and co (normally woman can respond well) some are sensative to angiotensin 2 which causes vasoconstriction and vasospasms
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what are the 3 things that vasoconstriction do
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cell damage
decreased bld flow increased bp |
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what are s/s of preeclampsia
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face and hand edema
wg of 5-6 lbs week |
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as a result of vasoconstriction there is a decrease flow to what
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brain, heart, kidney, placenta
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with kidneys there is a decrease in renal perfusion what labs are seen
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dec grf
inc bun, creat, uric acid |
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with dec blood to kidney, there is also glomular damage and protein falls out, results in protein uria resulting in
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edema
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with edema, there is an increased viscocity of blood, what are the labs that are seen
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inc hct
dec plateles, coloid pressure (pulmonary edema) |
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with dec blood blow to liver-what happens? and what labs are seen
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liver edema-epigastric pain-sml hem
inc ast, alt (liver enzymes) |
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with a dec in blood to brain what are the s/s and what are the tests done
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ha, infarct, visual changes
inc dtrs (seizures) inc clonus |
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what are the interventions for hemorrhagic conditions
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monitor hypovolemic shock
monitor fetus promote tissue ox fluid replacement prep for surgery |
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what are the labs that are taken with hem conditions
what are they looking for |
pt
ptt fibrinogen d dimer (dic) clin hauer betke looking for mixing |
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with hyperemesis gravidarum when does this begin and when do symptoms start
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begins before 20th week
sx by 6 weeks |
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what are the complications
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acid imbalances, vik k, electrolytes, dehydration
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what could it be r/t, and what is the mom sent home with
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hormones and phhyschosocial abn
zofran or regalan pump |
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what are two interventions for hyperemesis
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monitor and drink fluids between vomitting
sit up after eating |
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what is the cure for preeclamsia and what are risk factors
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delivery
obese, chronic htn, dm, aa women, vascular/kidney ds, american indian |
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what are some drugs used for preeclampsia
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fish oil, prenatals, antioxidant therapy, vit e, baby aspirin, cal/mg supplements
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what are the s/s of preeclampsia
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blurred vision, ha
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when does preeclampsia usually happen?
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2nd trimester
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with preeclampsia you are kept on bed rest for how long
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keep on bedrest until 38 weeks or until worsened
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what is considered severe PIH
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160/110 with other s/s (ha blurred vision)
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what is the antepartum management for preeclampsia
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bedrest
antihypertensives anticonvulsants |
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what is the therapeutic level of mag sulf how often is it checked
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4-8 therapeutic
q6h |
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mag sulfate is used for seizures and is a cns depressant what does it cause 2
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decreased reflexes, lethargy
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how long is mag sulfate used for after delivery and what is it usually used with;
when is mag given |
used w buritrol
24-48 hrs given w brisk dtr |
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eclampsia you see tonic clonic seizures how long are they usually
what does the strip look like |
1 min
poor strip |
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what are the 3 drugs that are given for seizures
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fenolbarbitol, ativan, lorazepam
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what are the signs of an oncoming seizure
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ora
eyes go back in head few min they arent right |
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what is help
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hemolysis
elevated liver enzymes low plateles |
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help is always ass with what? decreased plt and mild preeclampsia may have what
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severe preeclampsia
help |
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if you have help you are at increased risk for what
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dic
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at what bp do drs get worried
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150/100
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what are the bp meds used during pregnancy
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aldomet (not good)
nifetapine (procardia) lebetafol w/ aldomet hydrolozine IVP for ER only |
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if cvs is done what is needed? if husband is rh - the baby is?
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rhogam
father - no way baby is + |
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with direct coombs what are you looking for what is seen
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looking for antibodies if high, jaundice
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indirect coombs is on who
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mom
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if coombs is - then + what happened
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had mixing at some point
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with incompatability what are they worried about
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hydrofetalis
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abo incomp means if mom is o and baby is?
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anything but o
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igg crosses placenta and does what
igm does what |
igg cause hemolysis or rbc
igm most antibodies |
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after delivery check coombs, a b ab baby will be
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o---??
test answer is o |
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if blood vessels rupture/get damaged what are we worried about r/t dm
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blind
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what are the problems r/t powers
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ineff uc
hypotonic dys hypertonic dys ineff maternal pushing |
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what are some problems r/t the passanger
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fetal size (macrosomia, shoulder dystocia)
abn presentation (op, breech, transverse) multifetal preg fetal abn (hydrocephalus, tumor) |
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what are some problems r/t the passage
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small contracted pelvis
shape of pelvis (gynecoid, anthropoid, android, platypelloid) |
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what are some problems with the psyche
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maternal exhaustion
pain perception |
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what are some abn labor durations
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prolonged, precipitate labor
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what is dystocia
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abnormal or diff childbbirth
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what are some causes of prom
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infection, incompetent cervix, fetal malpresentation, polyhydramnios, weak amniotic sac, procedures, intercourse
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what are some complications of prom
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maternal/fetal infection, chorioamnionitis
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what is the management for prom
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amniocenteis or pooledd fluid for fetal lung maturity, antibiotics, bethamethasone, nst, bpp
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what are the nursing considerations for prom
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monitor for infections
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what is prl
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after 20th week before 37th week
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what are some ass factors with ptl
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uterine irritability/bleeding, dehydration, infection, anemia, incompetent cervix, prom, abnormalities
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what are some signs of ptl
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ucs, baby balling up, cramps, backache, pelvic pressure, prom, vag bleeding
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what are the drugs that cause contractions to stop and also used for ptl
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nifedipine, idomethacin
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what drugs are used to stop ptl
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rest fluid antibiotics
tocolytics: terbutaline, mag sulfate betameth: lung mat |
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how do you pretict ptl
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cervical length
fital fibronectic infections |
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how do you id ptl
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frequent prenatal visits (usually not a big chance if you get checked)
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what are some placental abnormalities
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accreta, increta, percreta
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why are the placental abn an emergency
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bc they are all risk factors for pphem
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what is accreta, increta, percreta
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a-placenta grows slightly into myometrium
i-placenta grown deeply into myometrium p-perforation of uterus by placenta |
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what two things may be necessary
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hysterectomy blood transfusion
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what is a prolapsed cord
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compressed by presenting part-interrupted blood flow and reduced oxygen
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what are some causes of prolapsed cord
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high station, small fetus, breech, transverse, polyhydramnios
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what are signs of prolapsed cord
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cord visual
palpated on ve fhr |
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what is the management of prolapsed cord
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pressure on cord to improve blood flow, oxygen, cesarean
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what are the 3 types of uterine rupture
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complete, incomplete, dehiscence
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what are the causes of rupture
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previous uterine surgery, classical incision
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what are the s/s of rupture
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abd pain, hypovolemic shock, fetal distress, absent fht, no uc, palpate fetus
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what is the management of rupture
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cesarean, uterine repair or hysterectomy, blood transfusion
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what are the nursing considerations for rupture
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give pitocin carefully, watch for hypertonic ucs, give terbutaline prn, assess shock
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what are some causes of uterine inversion
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pulling on cord, excessive fundal pressure, adherent placenta, weak uterine wall
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what are the signs of inversion
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uterus not felt in abdomen, uterus seen in vagina, pain, hem, shock
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what is the management for inversion
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replace uterus, hysterectomy, iv fluids, blood, tocolytic drugs
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what are the nursing considerations for inversion
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correcting shock, foley cath, npo stable
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what is the cause of anaphylactoid syndrome: amniotic fluid embolism
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amniotic fluid is drawn into maternal circulation to lungs
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what are the signs of afe
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resp distress, decreased cardiac function, circulatory collapse
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what are the predisposing factors for early postp hem
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overdistended uterus, multiparity, prolonged labor, induction, placenta retention
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what are the signs of early hem
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boggy or high fundus, excessive bleeding with large clots
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what is the management of early hem
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fundal checks and massage, express clots, check bladder, iv pitocin, methergine im, hemabate im, cytotec pr, bimanual comp, iv fluids, blood
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what are the predisposing factors of early postpartum hem (trauma to birth canal-hematoma)
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macrosomic infant, induction, forceps, vacuum
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what kinds of lacerations are seen w the birth canal
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vaginal, cervical, perineal
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what is the management for trauma to birth canal
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surgical repair of lacerations, ice to small hematomas, large require incision and drainage
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what are the predisposing factors of late postpartum hem
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placenta fragments, clots, manual removal of placenta, H/O pp hem, infection
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what is the cause of late postpartum hem and when does it occur
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subinvolution
occurs 6 days to 8 weeks after birth |
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what is the management for late postp hem
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pitocin, methergine, hemabate, dilation and curettage (d &c), antibiotics
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how much can the body tolerate in blood loss
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1500-2000ml
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how does the body compensate for hypovolemic shock
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blood shunted to vital organs: brain, heart, kidneys
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what are the signs of hypovolemic shock
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pale, cold skin, tachycardia, hypotension, tachypnea, urine output decreases to less than 30ml per hr
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what is the management for hypovolemic shock
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control bleeding, blood transfusion
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what are the nursing considerations for hypovolemic shock
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blood pressure and pulse, fundal and lochia check, o2 sat
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what are the labs seen with hypovolemic shock
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hgb, hct, foley, oxygen via mask
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what are the thromboembolic disorders 3
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venous stasis, hypercoagulation, blood vessel injury
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what are the predisposing factors for thromboembolic disorders
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varicose veins, obesity, thrombophlebitis, smoke, oral contraceptives, multigravida
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what are the signs of superficial venous thrombosis
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swelling, redness, warmth, pain
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what is the management for superficial venous thrombosis
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analgesics, rest, elastic stockings, anticoagulants not needed
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what are the s/s of dvt
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swelling of leg, heat, tenderness, cool
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how do you dx dvt
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homans sign, ultrasound, doppler flow, mri, venography
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what is the management of dvt
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bedrest, heparin until labor, coumadin postp, analgesics, antibiotics
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how do you prevent dvt
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loose clothing, avoid prolonged sitting
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what is pulmonary embolism
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blood clot or amniotic fluid debris that occludes blood flow to lungs, dvt
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what are the signs of pe
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dyspnea, chest pain, tachycardia, tachypnea, cough
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what is the management of pe
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thrombolytic drugs, morphine, dopamine, oxygen, hob elevated, heparin
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what is the nursing considerations for pe
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maintain open airway, monitor client
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with pueperal infection what is seen
|
fever of 100.4 after 1st 24 hours
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what are some puerperal infections
|
bacterial infections, metritis, wound infection, uti, mastitis, septic pelvic thrombophlebitis
|
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what are the risk factors for infection
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c/s, rapid delivery, macrosomia, cavuum, forceps, manual removal placenta, lacerations, episiotomy, catheter, prolonged rom, ve
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what are the signs of endometritis
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fever, chills, uterine pain, foul lochia
|
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what is the tx for endometritis
|
antibiotics
|
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what are the signs of wound infection
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edema, redness, pain
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what is the management for wound infection
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incision and drainage, antibiotics, analgesics
|
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what are the signs and tx of uti
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dysuria, frequent urination, fever
antibiotics |
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what do you teach your pt with uti
|
wipe front to back
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what is the etiology of mastitis
|
staph aureus enters through cracked or blistered nipple
|
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what are the s/s of mastitis
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flu like, fever, ha, red area
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what is the managment for mastitis
|
antibiotics, cont breastfeeding or pumping, abscess must be drained
|
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what are the signs and management for septic pelvic thrombophlebitis
|
signs: pain fever tachycardia
management: antibiotics, haparin |
|
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what are the factors for ppdepression
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hormones, lack of sleep, lack of support, marital dysfunction
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what are the s/s of ppdepression
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fatigue, unable care for self or baby
|
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what is the management for ppdepression
|
rest, antidepressants, psychotherapy, ect
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what is postpartum psychosis
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sleep disturbance, confusion, hallucinationss, delusions, throughts of killing herself or baby
|
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what is the management of ppdepression
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hospitalization, antidepressants, antipsychotic
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what are the interventions for thermoregulation
|
neutral thermal environment, wearning to pen crib
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why do babies tend to have pain
|
too much stimulation
|
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why do they have problems with infection
|
passive immunity from mom and immature immunie system
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what are the interventions for nutrition and preterm infant
|
parenteral feedings, enteral feedings, gavage feedings, oral feedings
|
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with babies how do the babies progress with feeding
|
24-28 weeks tpn, then gavage, then nippling
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when do babies get to leave nicu
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when they are not aapneic, gain weight, maintain temp they tend to say into nicu until due date
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what is the interventions for rds
|
give surfactant
|
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what babies tend to have rds
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asphixia, dm moms, c/s, not enough cortisol
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how do you tell if a baby is having trouble breathing
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tachypnea, tachycardia, nasal flaring, zyphoid retrations, audile grunting, cyanosis
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what abg levels do yous ee
|
increased co2 and decreased o2
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what does the cxr show
|
atalextracsis
|
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what is a requirement for bronchopulmonary dysplasia
|
still being on oxygen after 28 days of life
|
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what weight do you usually see with bpdysplasia
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1500gm or less
|
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what interventions do you do for bpdysplasia
|
mom steroids to prevent ards minimize o2 needs
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what is a periventricular intraventricular hemorrhage and how do you dx
|
brain or head bleed, utz and head circumfrance
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when do babies tend to get periventricular intraventricular hemorrhage
|
less than 32 weeks or 1500gm
|
|
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how is periventricular intraventricular hem graded
|
1-4 3-4 have neurological defesets
|
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when do babies tend to get retinopathy of prematurity and how do you get it
|
24 weeks
damage to retina (prolonged sepsis, decreased ventilation, abn vision) |
|
|
what are the s/s of necrotizing enterocolitis
|
abdomnimal distention and diff breathing
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what is necrotizing enterocolitis
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death of intestines which leads to cellular death
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with necrotizing enterocolitis what do you do r/t feedings
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dont feed early look for residual-ischemia-death of intestines
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with posterm infants what do we worry about
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maconium stained fluid, big peeling, skin, clavicals
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with small and large for gestational age what is diff about it
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diff protocol for hyperglycemia, hyperbilirubinemia, hypothermia, rds
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what is asphyxia
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lack of oxygen with oxygen
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with asphyxia what needs to be done
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stimulate pos pressure-oxygen-suction
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what babies tend to get transient tachypnea
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c/s
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what is transient tachypnea s/s
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increased respirations (60-80)
something resolves on its own term cough sneeze reabsorbion |
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with persistent pulmonary hypertension of the newborn when does it go away
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every 4 hours
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when is tachypnea something to look into
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when it associated with something else or other s/s
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with meconium aspiration syndrome how do you monitor
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the degrees vary
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what are the two interventions with hyperbilirubinemia
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phototherapy
exchange transfusions |
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what are the two transmissions of infections
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vertical
horizontal |
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what are the nursing considerations for prenatal drug
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feeding
rest bonding |
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with congenital cardiac defects what are the classifications
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acyanotic defects
cyanotic defects defects w increased pulmonary blood flow defects with obstruction of blood flow defects with decreased pulmonary blood flow mixed defects |
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what are the manifestations of congenital cardiac defects
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cyanosis
heart murmurs tachycardia and tachypnea |
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what are the predisposing factors for early postpartum hem
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overdistended uterus, multipartiy, prolonged labor, induction, placenta retention
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what are the s/s early postpartum hem
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boggy or high fundus, excessive bleeding with large clots
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what is the management of early postpartum hem
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fundal checks and massage, express clots, check bladder, iv pitocin, methergine im, hemabate im, cytotec pr, bimanual compression, iv fluids, blood
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what are the predisposing factors for early pp hem
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macrosomic infant, induction, forceps, vacuum
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what are the 3 types of lacerations for early pp hem
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vaginal, cervical, perineal
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what is the management for early pp hem
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surgical repair of lacerations, ice to small hematomas, large require incision and drainage
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what are the predisposing factors to late pp hem
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placenta fragments, clots, manual removal of placenta, h/o pp hem, iinfection
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how much blood loss can the body handle
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1500-2000ml
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with compensation of hypovolemic shock what does the body do
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blood shunted to vital organs (brain, heart, kidneys)
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what are the s/s of hypovolemic shock
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cold skin, tachycardia, hyptension, tachypnea, urine output decreases to less than 30ml per hour
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how do you manage hypovolemic shock
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control bleeding, blood tansfusion
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what are the nursing considerations for hypovolemic shock
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blood pressure and pulse check, fundal and lochia check, o2 sat
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what are the labs r/t hypovolemic shock
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hgb, hct, foley, oxygen via mask
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what are the 3 thromboembolic disorders
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venous stasis, hypercoagulation, blood vessel injury
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what are the predisposing factors for thromboembolic disorders
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varicose veins, obesity, thrombophlebitis, smoke, oral contraceptives, multigravida
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what are the s/s of superficial venous thrombosis
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swelling, redness, warmth, pain
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what is the management for superficial venous thrombosis
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analgesics, rest, elastic stockings, anticoagulants not needed
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what are the s/s of dvt
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swelling of leg, heat, tenderness, oool
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how do you dx dvt
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homans sign, utz, doppler flow, mri, venougraphy
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what is the management for dvt
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bedrest, heparin until labor, coumadin, pp, analgesics, antibiotics
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what is the prevention of dvt
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loose clothing, aboid prolonged sitting
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what is a pe
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blood clot or amniotic fluid debris that occludes blood flow to lunds
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what are the s/s of pe
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dyspnea, chest pain, tachycardia, tachypnea, cough
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how do you manage pe
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thrombolytic drugs, morphine, dopamine, oxygen, hob elebvated, heparin
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what is the nursing considerations for pe
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maintain open airway, monitor client
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what is puerperal infection risk factors
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c/s, rapid delivery, macrosomia, bvacuu, forceps, manual removal placenta, lacerations, episiotomy, catheterization, prolonged rupture of mem,vag exams
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what is the main sign of pueperal infection
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fever of 100.4 after 1st 24 hr
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what are the signs and tx of endometritis
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fever, chills, uterine pain, foul lochia
antibiotics |
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what are wound infectiosn s/s (puerperal infection)
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edema, redness, pain
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what is the management for puerperal infection
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incision and drainage, antibiotics, analgesics
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what is the uti s/s
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dysuria, frequent urination, fever
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what is the etiology of mastitis
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staph, aureus enters through cracked or blistered nipple
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what is the s/s of mastitis
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flu like fever, ha, red area
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what is the management for mastitis
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antibiotics, cont bfeeding or pumping, abscess must be drained
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what are the s/s and management of septic pelbic thrombophlebitis
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s/s pain fever tachycardia
management antibiotics, heparin |
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what are the factors of pp depression
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hormones, lack of sleep, lack of support, marital dysfunction
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what are the s/s of pp dep
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fatigue, unable to care for self or baby
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what is the management of pp dep
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rest, antidep, psychotherapy, ect
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what is pp psychosis
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sleep disturbance, confusion, hallucinations, delusions, thoughts of killing herself or baby
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what is the management for pp dep
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hospitalization, antidep, antipsychotic
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hyperglycemia in uterus = what
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marcomia
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what does the baby have once the cord gets cut
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hypoglycemia
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type one gets what and why
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iugr bc they have vascular changes
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babys that are uncrontrolled in first trimester (type 1 2) are what
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the ones to worry about
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what are the 3 things that are seen with dm
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neural tube and tube defects and cardiac issues
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when are gdm testing done
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28 weeks
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resp distress is a huge problem w what
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dm
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what else is a baby def in besides sugar
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calcium
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with hypoglycemia what lab values do you see an increase in
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increased retic
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with a dm mom tell the mom to do what
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kick counts
screening tests (measure back of neck) anatomy utz/4 marker screen nst amniotic fluid index ecg |
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what are the classifications of dm
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type 1
type 2 a1gdm a2gdm |
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what are fetal effects of dm
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congenital malformations
variations in fetal size |
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what are the neonatal effects of dm
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hypoglycemia
hypocalciumemia hyperbilirubinemia rds |
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fasting __ as we age
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increase
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insulin needs __ a lot when pp bc why
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decrease
bc placenta is gone |
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with gdm __ mal formation then needs a 28 week screening
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no
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gdm how many accuchecks daily and predm
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q4x
q8x |
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what happens r/t trimesters and glucose needs
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decreased in first
increases during second |
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how is the diet supposed to be with dm
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diet low in sugar, high in fiber, limit to 30-40% carbs, constant;ly feeding
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what are the risk factors for gdm
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carb intolerance that develops during preg (change diet--insulin)
obesity, ama, family hx, previous baby 400gm, prior chrom def, prior iufd, prior gdm, multifetal preg |
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how do you identify for gdm-what is the cycle
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1 hr gulcose screening-challange test (soda) 50mg, then check hr later-then should be less than 140, if not glucose tolerant, test 4 hr test-fasting then 100gm glucose soda--1hr--2hr--3hr
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what should 1, 2, 3 hr test be
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180, 155, 140
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when does gdm become dx
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if any 2 above are abn
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what are the teaching for dm
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teaching, dietary mgmt, hypo/hyperglycemia
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high fasting glucose would indicate what
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type 2 dm
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if you have hyperglycemia out of nowhere what does it indicate
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infection
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when does hgb levels indicate anemia
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1st trimester hbg less than 11
2nd less than 103.5 |
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what is the tx for iron
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1000mg iron sup
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what is the s/s of anemia
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pallor, lethargy, dizziness, pica, ha
decreased o2 cap |
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what effects does the baby have w anemia
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dec hgb and iron
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what do you give the mother besides iron
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ferrasulfate 1-3x daily 320mg
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what are the se of iron
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black stool, constipation
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what is folic acid needed for
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placental growth
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with folic acid def what defects do you see
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neural tube def-spinal bifida-cardiac anomolies
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what is the dosage for folic acid
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400mcg at least
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with thalassemia what cant you give
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iron
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with thalassemia what is the labs
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look at cbc, h/h, mcv, dna testing for thal and sickle (hetero/homo) a and b
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where do you get cmv and what kind of infection is it
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daycare; fetal infection cranial ab/iugr
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how is rubella transmitted and what are the s/s; does it cross the placenta
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air droplets; fever rash
crosses placenta (aport) |
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with varicella what trimester is it life threatening
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3rd
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the tx for herpes is at what weeks and what what drugs are used
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36 weeks
antiviral |
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what are the s/s of parvo
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rash, fever, join pain (main), fetal death, anemia, hydrops fetalis, no tx
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with hiv how do moms get treated
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need to be treated during preg
azt after 13-18 weeks 100mg 5x day labor azt iv no bleeding |
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with hep what do you do
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give immunoglobin and vaccine
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with toxoplasmosis where is it from and what do you give
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from cats and meat thats not cooked; protaxoin, flagyl
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what is the gbs tx during labor
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2 doses during laboar amapcillin or penacillin
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